Creating a culture of respect and interprofessional teamwork on a labor and birth unit: a multifaceted quality improvement project

ABSTRACT

Interprofessional teamwork is essential to high-quality healthcare, however disrespect and incivility amongst team members is a challenge to creating and sustaining effective teams. We describe and assess the impact of a multifaceted improvement project with the primary intervention being a Compassionate Communication (CC) training on a Labor and Birth unit. Our hypothesis was this improvement project would increase staff members’ capacity for perspective-taking and self-reflection, which would in turn correlate with positive interpersonal interactions, respect and teamwork. Secondly, we hypothesized that enhanced respect and teamwork would correlate with enhanced affective commitment to the organization. Staff was surveyed midway through the project and 6 months after the CC training. A total of 74 (57%) staff completed the initial pre-training surveys and 50 (38%) staff completed post-training surveys. At 6 months post-CC training we saw changes in self-reflection and an awakening of self-awareness. There were no significant changes in perspective-taking. However, we did see changes in staffs’ perceptions of respect and teamwork. Team members’ affective commitment to the organization increased. In this Labor and Birth setting, a multifaceted improvement project with the primary intervention being CC training was beneficial in improving a culture of respect and interprofessional teamwork.

KEYWORDS:

• Interprofessional teamwork
• compassionate communication
• respect
• incivility

Acknowledgments

We would like to acknowledge the assistance of Maria Smyth, and Drs. Leslie Macdonald, Edwin Huang, Jennifer Shaw in planning and implementing this project.

Declaration of interest

The authors report no conflicts of interest.

Additional information

Funding

The authors received funding from the Mount Auburn Hospital’s Medical Executive Staff Committee for this project. The Mount Auburn Hospital Department of Obstetrics and Gynecology provided funding for the CC trainer’s services. Participants’ salary support to attend the CC training was paid by the Department of Obstetrics and Gynecology from monies allocated for this purpose by CRICO, the department’s malpractice insurer.

Notes on contributors

Julie Mann

Julie Mann, MSN, CNM is the Assistant Director of Midwifery and Project Manager of Quality Improvement on Labor & Delivery at Mount Auburn Hospital. Her work focuses on improving the culture of communication and respect among colleagues as well as well as patient and family members. In this effort, she has closely collaborated with the Institute of Healthcare Improvement.

Beth Lown

Dr. Beth Lown is Associate Professor of Medicine, Harvard Medical School, Boston, MA and Chief Medical Officer of the Schwartz Center for Compassionate Healthcare, a non-profit organization dedicated supporting healthcare professionals and staff in bringing compassion to all healthcare experiences. She is an internist and director of faculty development at Mount Auburn Hospital, Cambridge, MA, a teaching hospital of Harvard Medical School.

Sharon Touw

Sharon Touw, MPH, is an Epidemiologist at the Institute for Community Health where she has worked for six years managing research and evaluation projects and conducting data analysis.